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Wellness programs focused on reducing risky behavior cut health care costs

Cohesive wellness programs focus on healthy habits

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Wellness programs focused on reducing risky behavior cut health care costs

WASHINGTON — Designing workplace wellness programs to address employees' risky health behavior could be the most effective way to truly reduce health care costs, experts say.

“The key here is risk prevention,” said Stephen Hartley, director of health and wellness analytics at OptumHealth, a division of Minnetonka, Minn.-based UnitedHealth Group Inc.

A pair of studies OptumHealth conducted last year found that annual health care costs for employees deemed “at risk” in six of nine health risk categories — including stress, lack of physical activity, high cholesterol, high blood pressure, high body weight and use of anti-anxiety/depression medications — were significantly higher than costs generated by low-risk employees.

Employees were deemed at risk if they reported moderate to high levels of any one risky behavior. The studies tracked the two-year migration of more than 3,300 companies' employees from low-, moderate- and high-risk thresholds and compared those changes with employers' overall health care costs during the same period.

The results showed that year-over-year health care cost increases were the lowest for employees who maintained an overall low-risk rating throughout the study period, and were second-lowest for employees who migrated from the high-risk to low-risk category. Conversely, year-over-year medical cost increases were the greatest among employees whose risk rating went from low- to high-risk during the two-year span.

“If you're going to focus on risk change, the opportunity obviously lies in moving people from high-risk to low-risk, and there's an even greater opportunity in the short run in keeping your low-risk employees in the low-risk category,” Mr. Hartley said during a session at the National Business Group on Health's annual conference in Washington.

The studies' findings “definitely underscore the need for a focus on risk prevention in a wellness program,” he said.

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Dee Edington, founder and chairman of the Ann Arbor, Mich.-based wellness research firm Edington Associates L.L.C., said tracking the “natural flow” of employees' migration between health risk levels is the “gold standard” of wellness performance measurement.

“We shouldn't be doing any more return-on-investment studies,” Mr. Edington said. “They're too insignificant. The same procedure done in one part of the country will probably give you a completely different result (financially) in another part of the country, but the overall patterns are the same.”

A majority of employers surveyed in Towers Watson & Co.'s 2013/2014 “Staying@Work Report” cited many of the same health risks examined in OptumHealth's research as primary lifestyle risks among U.S. workers: stress, lack of physical activity, obesity and poor nutrition.

However, only 28% of employers in the Towers Watson research said improving their employees' physical health was among their top wellness priorities, and only 15% said their top wellness priorities included improving their workforce's emotional or mental health.

As a consequence, participation rates for lifestyle change and health management programs, such as weight management and tobacco-cessation programs, were well below 20% this year.

Moreover, 50% of employers said the various programs designed to drive health awareness and engagement among their employees have not been organized into a cohesive wellness strategy.

“That's been a problem for a while,” said Helen Darling, president and CEO of the Washington-based NBGH. “Just having programs in place doesn't really work if you don't tie them together in a way that creates synergies among the different initiatives.”